Transcript of "Consultant Staff In Radiology And Nuclear Medicine"

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SOUTHAMPTON UNIVERSITY HOSPITALS NHS TRUST
FELLOW IN ABDOMINAL IMAGING AND INTERVENTION RADIOLOGY
INTRODUCTION
This post is subject to the Terms and Conditions of service determined by the Southampton
University NHS Trust Board. These Terms and Conditions are the same as those nationally
negotiated within the Trust.
Southampton University Hospitals Trust was established on 1 April 1993.
The Trust employs over 5000 people on 7 sites in and around the City of Southampton. The
sites are:-
Southampton General Hospital.
908 beds for In-patient services. Day case facilities, Out-Patient facilities, Accident and
Emergency Department and extensive academic facilities for under and postgraduate staff.
Princess Anne Hospital
204 beds for In-Patient services, Day case facilities and Out-Patient facilities.
Royal South Hants Hospital.
238 beds for In-Patient services, Day case facilities and Out-Patient facilities, Postgraduate
medical centre and library.
Southampton Eye Unit
The Southampton Eye Unit opened at the end of March 1994. Prior to this, Ophthalmology
was based at the Southampton Eye Hospital in Wilton Avenue, Southampton. The Eye
Hospital has been the home of specialist eye services in Southampton for more than 100
years.
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and the surrounding DGH’s. FRCR I, IIa and IIb are integral to the scheme with well
structured courses delivering the examination syllabus. In addition there are internal written
tests for assessment of basic knowledge of Anatomy, Physics and Radiographic techniques
at the end of year 1 and an Emergency Radiology course with exam prior to commencing on-
call. A post FRCR course is available. e-learning / assessment packages in emergency
radiology relating to Neuro and multi-trauma are being developed.
GE PACS was installed in 2006 and links SGH, RSH and from Jan 2007 the new Lymington
Hospital.
Royal South Hants Hospital
The Radiology Department at the RSH is being upgraded as part of the conversion of the
hospital into an NHS treatment centre, which will be providing most diagnostic Radiology
services for hospital and GP out patients. A Sigma 1.5 MR scanner was installed in 2005.
Digital fluroscopy will be relocated to the SGH site during 2007.
A self-contained Breast Screening Unit is situated close to the X-ray Department. This is being expanded
to encompass extension to the Breast Screening Programme and integration with the symptomatic
service. It will comprise three Mammography rooms, two with digital stereotaxis, and two ultrasound
rooms together with on site Cytology, two clinical rooms and counselling facilities
Southampton General Hospital
The General Radiology Department in the Centre Block was completed in 1978. It comprises 12 X-ray
and 4 Ultrasound rooms including digital Fluoroscopy, Tomography and general purpose X-ray rooms.
The fluoroscopy service is currently being re-configured with replacement of all the fluoroscopy systems.
A dedicated Interventional Radiology Suite with a three-bedded Day Case Unit and a further two-bedded
recovery area are located within the General Department. A Siemens Flat detector Digital Angiographic
room (Rm 7) was installed in 2005. This is fully equipped for endovascular procedures. This room has
integral US with colour doppler, Intra-vascular Ultrasound, high speed Rotational and 3D Angiography. A
second Interventional room equipped with a Siemens Artis MP digital unit opened in Jan 2002. Again this
room is equipped with trans-abdominal Ultrasound with colour and power doppler capabilities, walled
gases and is equipped for GA and theatre cases. This room is used predominantly for non Vascular
Intervention including Hepato-biliary, other GI and Endoscopic Interventions, Uroradiology, Central Line
placement and lung biopsies. A third Phillips Digital C-arm multi-purpose room (Rm 6) opened in early
2008. This is used for a wide variety of fluroscopy as well as basic interventional procedures such as
central line placement, discography and occasionally nephrostomy and colonic stent placements.
A three-bedded Radiological Day Case Unit opened in August 2000. Plans are underway to create an 8-
10-bedded unit within the main Radiology department. Whilst the patient is within the Radiology
Department the Consultant Radiologist will have the responsibility as Lead Clinician.
CT facilities have recently been updated and scans are being undertaken on 3 scanners on the SGH
site: There are 2 Siemens multislice scanners in a new purpose built CT dept one adjacent to the IR
suite (64 slice) and in the second in the Wessex Neurological Centre (16 slice).
A further 4 slice scanner is situated in the Radiology Department in the Oncological centre. Plans are
underway to add an additional CT scanner in the C level XRay department to improve interventional
capacity and meet ever tightening waiting list targets.
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PET/CT is now available both from a visiting mobile facility for 1 day per fortnight and also 1 day a
week at the Spire Southampton Hospital.
The Southampton General Hospital Radiology Department has approximately 120,000 patient
attendances per annum.
There is a 4 room Ultrasound Department attached with Philips and ATL 5500 and 5000 scanners as well
as Toshiba Aplio and Xario scanners.
A separate Childrens' X-Ray Department is sited adjacent to the General Radiology Department. This
comprises four x-ray rooms including a digital fluoroscopy room, and an ultrasound room. The
Department has recently been rebuilt and re-equipped. There are two dedicated Paediatric CT lists and
1.5 Paediatric MRI lists (one of which is a GA list), with a further GA list fortnightly. The Department
provides specialist paediatric imaging to the Child Health Directorate, Paediatric Orthopaedics, the
Paediatric Intensive Care Unit and surrounding Trusts, as well as providing direct access to Primary Care
and reporting all Paediatric Accident and Emergency imaging.
The Department of Nuclear Medicine is responsible for routine radionuclide imaging and other isotope
procedures for the SUHT Hospitals and also provides a service for other District General Hospitals in the
Wessex Region where radionuclide facilities are not available. Four gamma cameras, and a whole body
counter are sited in the Department together with advanced computer image processing and a patient
database system. The Department also has excellent physics and biochemist support. The Hospital
Pharmacy provides radiopharmacy facilities. Research facilities are available for the development of new
radionuclide imaging and therapeutic techniques.
The Wessex Neurological Centre is also housed within the General Hospital. This is the Regional
Centre for Neurosurgery, Complex Neurology and Clinical Neurophysiology. Housed in a purpose-
built block the Centre has 39 Neurosurgical and 30 Neurological beds with a 13 bed Intensive
Treatment Area. The Centre is served by its own radiological facilities. A Bi-planar Siemens Artis
dedicated neuro-interventional angiography room opened in March 2004. This room allows complex
interventional procedures under full theatre conditions. The CT Scanner is a Siemens Sensation 16
scanner in installed 2005. Adjacent to the Neurological Centre is a purpose-built MR Suite housing a
Siemens 1.5T Symphony and a Philips 1.5T scanner. This is shared between the Radiological
Specialties.
A new Phase 1 Cancer Centre has been built on the SGH site with 3 new additional linear accelerators
and ward accommodation for Radiotherapy and Medical Oncology. The Centre includes a plain film
diagnostic Radiology Room, an Ultrasound Room and an 8 slice GE CT scanner. Phase 2a has just
commenced building.
Trust wide PACS became operational in July 2006.
The Cardiothoracic Radiology Department is accommodated in a suite of offices on E Level of the
General Hospital close to the Cardiothoracic wards, cardiac catheter rooms and operating theatres.
There are four digital cardiac catheter rooms, all equipped with Siemens HICOR equipment and C-arms.
Two single plane rooms are less than five years old and the biplane room has just been replaced. All four
rooms are now linked to a digital archive facility. The accommodation includes an angiography reporting
room and a reporting/teaching room which also houses the Teaching Film Collection. Radiological
examinations other than cardiac catheterisation and portable films are carried out in the Main Radiology
Department and the CT and MRI scanning suites. There are three dedicated chest CT sessions and one
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cardiac MRI session per week in addition to emergency work and the Department also carries out
interventional procedures in the chest. The Department provides a specialist cardiac and pulmonary
imaging service to the Trust and beyond. A major expansion of cardiac facilities is currently underway.
Royal South Hants Hospital
The Radiology Department at the RSH is being upgraded as part of the conversion of the hospital into
an NHS Diagnostic and Treatment Centre, which will be providing most diagnostic radiology services
for hospital and GP outpatients. There is a GE Signa
1.5 T MR scanner, two digital fluoroscopy and two digital radiography rooms. Two purpose-built
orthopaedic radiology rooms, a twin-bedded IVU suite, a clean screening room with a C-arm machine
and an IGE CTI CT scanner are already in use. The Department currently undertakes some 60,000
examinations per year.
A self-contained Breast Screening Unit was relocated to the Princess Anne Hospital in 2007. The
majority of screening is performed on three Mobile Units with screening of the local population,
multidisciplinary assessment clinics and stereotactic localisations taking place in the Breast Screening
Unit.
DETAILS OF THE POST
This post is designed to fulfil the criteria for training in Abdominal and Non-vascular
Interventional Radiology as laid out in the curriculum for subspecialty training. It can also be
adapted to provide a second year of training in year 5-6 for trainees wishing to become
full-time Interventional Radiologists.
Southampton is one of the busiest vascular and interventional units in the UK,
Here are the workload figs for 1990-2008.
1990 1994 1997 2001/02 2002/03 2003/04 2006/07 2007/08
Biliary
Diagnostic PTC 1 10 5
Biliary drains 70 51 49 62 58
Drain
change/removal
29 30 10 38 24
Stents 43 40 46 33 35
Balloon dilatation 15 15 22 15
Stone removal 3 3 4 2 2
ERCP 321 282 295 302 380
Percutaneous
Cholecystostomy
4 2 9 4
Total 57 125 168 486 423 435 464 504
Hepatic
Angio/CTAP 2 11 4 4 1
TACE 11 17 20 47 55
Embolization 4 2 8 7 31
TIPS 0 14 31 17 18 14 11 21
TIPS intervention 0 14 77 12 17 5 12 7
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Bone metastasis
Embolization
0 0 3 5 10
Other Metastasis
Embolization
0 0 3 1 5
Total 6 6 15
IVC Filter 10 12
Unspecified
Embolization
3 10 44 44 47 38 17 15
Long Lines 185 232 248
The final job plan will be tailored to some extent to the training needs and special interests of
the appointee, but in general he/she would have 6 procedural sessions in the Interventional
Suite or performing other relevant imaging procedures, including Angio-CT, MRI and
ultrasound, including Doppler.
1 day would be protected for study or an optional hands-on ERCP session and one session
for plain film reporting. Interventional sessions would be performed under supervision of a
consultant, but with an emphasis on hands-on experience. Direct surgical contact with intra-
operative hepatic, biliary and pancreatic ultrasound will be encouraged and attendance at
HPB and upper GI cancer MDTs will be expected.
Provisional Job Plan
AM PM
Monday Study Study / MRI
Tuesday Rm 7 / 15 / IO-U/S CT / ERCP / 15
Wednesday MDTs HPB and Upper GI Rm 15 / MRI
Thursday ERCP / 15 / MRI Rm 7 / 15
Friday Study Rm 7 / Emergencies
The Fellow will share in the teaching and training of SpR's and will share in the on-call
commitments. The post will be for 1 year and may be renewable subject to review.
EDUCATIONAL REVIEW
The educational supervisor will be Dr Nigel Hacking, Consultant in Abdominal and Non-
vascular Interventional Radiology. A training agreement will be formulated at the beginning of
the fellowship with a formal appraisal 6 months and there will be a RITA assessment in June.
RESEARCH
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The Fellow's existing research interests and current projects will be encouraged. There are
several current and projected research projects within the unit which the appointee could
become involved in.
VISITING
Candidates are encouraged to visit by arrangement with Dr CN Hacking, Consultant
Radiologist, Department of Clinical Radiology, Southampton General Hospital. Telephone
01703 796981 (Fax 01703 794038). Applicants will be reimbursed for the following interview
expenses.
1. Attendance for interview
2. Pre-interview visits for shortlisted candidates only (maximum of 2 visits)
NOTE
Because of the nature of the work for which you are applying, this post is exempt from the
provisions of Section 4(2) of the Rehabilitation of Offenders Act 1974 by virtue of the
Rehabilitation of Offenders Act 1974 (Exceptions) Order 1975. Applications are, therefore, not
entitled to withhold information about convictions and in the event of employment, any failure
to disclose such convictions could result in dismissal or disciplinary action by the Trust. Any
information given will be completely confidential and will be considered only in relation to an
application for positions to which the order is applied.
A similar memorandum will also accompany requests for references.
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